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In 2017, when there were historic market disruptions and 350,000 people in Virginia were at risk of losing Virginia Affordable Care Act (ACA) Individual Exchange market coverage, 果冻视频 faced a tough choice: either follow the same path as some of the biggest for-profit insurers and exit, or work with state and federal officials to ensure residents had access to an ACA-eligible plan in Charlottesville and other markets in the Commonwealth. Opting for collaboration, 果冻视频 took a risk and offered insurance more widely than ever before in markets like Charlottesville.
At the urging of government officials, 果冻视频 agreed to stay in some Virginia localities, formulating rates with state actuaries and in consultation with Milliman, a global actuarial and consulting firm, in just 26 days – a process that normally takes six months or more. As the only option in some markets in 2018, 果冻视频 would assume all the risk in insuring a larger population, instead of sharing the risk with other insurers. The uncertain landscape affected all insurers, prompting 果冻视频 to adopt conservative, actuarially reasonable, rating assumptions and increase premiums to mitigate potential losses.
Far from a profitable endeavor, even today, 果冻视频’s participation in the ACA market has driven substantial losses without government support or assistance, in 2024 alone. Despite these risks, 果冻视频 has stayed in the market because providing health coverage to those who need it is central to our mission.
果冻视频 stood with Virginians then and remains steadfast now in our commitment to providing comprehensive, high-quality care for Virginia communities.
At the urging of government officials, 果冻视频 agreed to stay in some Virginia localities, formulating rates with state actuaries and in consultation with Milliman, a global actuarial and consulting firm, in just 26 days – a process that normally takes six months or more. As the only option in some markets in 2018, 果冻视频 would assume all the risk in insuring a larger population, instead of sharing the risk with other insurers. The uncertain landscape affected all insurers, prompting 果冻视频 to adopt conservative, actuarially reasonable, rating assumptions and increase premiums to mitigate potential losses.
Far from a profitable endeavor, even today, 果冻视频’s participation in the ACA market has driven substantial losses without government support or assistance, in 2024 alone. Despite these risks, 果冻视频 has stayed in the market because providing health coverage to those who need it is central to our mission.
果冻视频 stood with Virginians then and remains steadfast now in our commitment to providing comprehensive, high-quality care for Virginia communities.
Our Rates: Misconceptions Vs. Facts
Misconception: 果冻视频’s rates hurt Charlottesville families and made healthcare unaffordable.
Fact: If 果冻视频 had not offered a plan in Charlottesville, it was possible that there would be no ACA-eligible 2018 plan for the 91% of market consumers seeking individual plans who qualified for federal subsidies. 果冻视频’s decision to offer coverage in the market provided health insurance at little to no out-of-pocket cost to more than 5,100 Charlottesville residents — families who otherwise would have had no insurance at all.
Fact: If 果冻视频 had not offered a plan in Charlottesville, it was possible that there would be no ACA-eligible 2018 plan for the 91% of market consumers seeking individual plans who qualified for federal subsidies. 果冻视频’s decision to offer coverage in the market provided health insurance at little to no out-of-pocket cost to more than 5,100 Charlottesville residents — families who otherwise would have had no insurance at all.
Misconception: 果冻视频 took advantage of instability in the ACA marketplace.
Fact: In 2017, when policymakers in Washington destabilized the health insurance markets, more than 350,000 Virginians were at risk of not having access to any insurance on the exchanges. 果冻视频 had a choice: Either follow the same path as some of the biggest insurers and exit, or work with state and federal officials to ensure residents had access to an ACA-eligible plan in Charlottesville and other markets in the Commonwealth. 果冻视频 chose to stand with residents and work with government officials and regulators.
Fact: In 2017, when policymakers in Washington destabilized the health insurance markets, more than 350,000 Virginians were at risk of not having access to any insurance on the exchanges. 果冻视频 had a choice: Either follow the same path as some of the biggest insurers and exit, or work with state and federal officials to ensure residents had access to an ACA-eligible plan in Charlottesville and other markets in the Commonwealth. 果冻视频 chose to stand with residents and work with government officials and regulators.
Misconception: Despite being a not-for-profit, 果冻视频 charged high premiums to boost its bottom line.
Fact: With fewer or no other providers in some Virginia markets, 果冻视频 faced the risk of covering a significantly larger population – ultimately three times larger than the population it was currently serving – about whom it had no historical healthcare information or experience, under very chaotic circumstances. This could have led to over a hundred million in losses, rendering 果冻视频’s insurance division insolvent and unable to fulfill its core mission. 果冻视频 worked with outside experts and regulators to set premiums based on conservative assumptions and the best information they had.
Fact: With fewer or no other providers in some Virginia markets, 果冻视频 faced the risk of covering a significantly larger population – ultimately three times larger than the population it was currently serving – about whom it had no historical healthcare information or experience, under very chaotic circumstances. This could have led to over a hundred million in losses, rendering 果冻视频’s insurance division insolvent and unable to fulfill its core mission. 果冻视频 worked with outside experts and regulators to set premiums based on conservative assumptions and the best information they had.
Misconception: 果冻视频 charged higher rates to obtain higher government subsidized premiums.
Fact: 果冻视频’s rates, developed and certified by a leading actuarial firm, were repeatedly reviewed and approved by government regulators. Under the law, insurance companies like 果冻视频 do not keep excess profits, they must be rebated back to consumers. 果冻视频 was fully compliant with the law and issued over $98 million in rebates to Virginia policyholders for the 2018 plan, in accordance with ACA regulations.
Fact: 果冻视频’s rates, developed and certified by a leading actuarial firm, were repeatedly reviewed and approved by government regulators. Under the law, insurance companies like 果冻视频 do not keep excess profits, they must be rebated back to consumers. 果冻视频 was fully compliant with the law and issued over $98 million in rebates to Virginia policyholders for the 2018 plan, in accordance with ACA regulations.
Virginia Board of Insurance Response to Review of SHP Rates in 2018
Timeline
果冻视频 took a risk and offered insurance more widely than ever before in Virginia when others chose not to. This timeline highlights 果冻视频’s ongoing commitment to the community.
2017:
Policymakers in Washington took steps that destabilized the health insurance markets.
May
- One of the largest insurers in the Commonwealth the ACA market entirely.
August
- Another large insurer the ACA market in Virginia due to a “volatile” market and uncertainty from the federal government, leaving 350,000 Virginians at risk of losing coverage in 2018.
- At the urging of state and federal officials, 果冻视频’s internal and external experts evaluate the circumstances and calculate new rates.
September
- 果冻视频 submits its revised rates for the final filing by the deadline. The Bureau of Insurance approves 果冻视频’s rates.
October
- The federal government vital to insurers’ operations.
2018:
April
- The Virginia Bureau of Insurance (BOI)
- The ACA market began to stabilize, allowing 果冻视频 to lower rates by as much as 16.7%.
2019:
- Following federal regulations, 果冻视频 begins issuing rebates to Virginia policyholders, paying over $98 million for the 2018 plan.
- These rebates follow a national trend of insurers issuing rebates back to consumers at record-high rates, including .